Tadalafil C20 (Cialis) by Hilma Biocare is a phosphodieste-rase 5 (PDE5) inhibitor indicated for the treatment of erectile dysfunction (ED) and the signs and symptoms of benign prostatic hyperplasia (BHP).

The recommended starting dose of Tadalafil (Cialis) for use as needed in most patients is 10 mg, taken prior to anticipated sexual activity. The dose may be decreased to 5 mg or increased to 20 mg, based on individual efficacy and tolerability.

The maximum recommended do-sing frequency is once per day in most patients. Tadalafil (Cialis) for use as needed was shown to improve erectile function up to 36 hours following dosing.

Tadalafil is not indicated for use in females and pediatric patients. Administration of Tadalafil to patients using any form of organic nitrate is contraindicated. Tadalafil (Cialis) was shown to potentiate the hypotensive effect of nitrates.

Patients should not use Tadalafil (Cialis) if sex is inadvisable due to cardiovascular status. Use of Tadalafil (Cialis) with alpha-blockers, antihypertensives or substantial amounts of alcohol may lead to hypotension.

Caution is advised when Tadalafil (Cialis) is used as a treatment for ED in men taking alpha-blockers.

Patients should seek emergency treatment if an erection lasts >4 hours. Use Tadalafil (Cialis) with caution in patients predisposed to priapism.

Patients should stop Tadalafil (Cialis) and seek medical care if a sudden loss of vision occurs in one or both eyes, which could be a sign of non-arteritic anterior ischemic op-tic neuropathy (NAION). Tadalafil (Cialis) should be used with caution, and only when the anticipated benefits outweigh the risks, in patients with a history of NAION.

Patients should stop Tadalafil and seek prompt medical attention in the event of sudden decrease or loss of hearing. Prior to initiating treatment with Tadalafil (Cialis) for BPH, consideration should be given to other urological conditions that may cause similar symptoms.